Ungayithola yini umdlavuza onje esiswini sakho? Ake sixoxe ngomdlavuza oyinhloko wesisu

Wake wezwa ngaleli gama elithi 'umdlavuza oyinhloko we-peritoneal'? Mhlawumbe akunjalo. Ngoba uhlobo lomdlavuza olungavamile. Kodwa kubaluleke kakhulu ukwazi ngalo, ikakhulukazi kwabesifazane. Namuhla, sizokhuluma ngalo kalula, ngendlela ongayiqonda.

Uyini Umdlavuza Oyinhloko Wesisu?

Kalula nje, umdlavuza oyinhloko we-peritoneal umdlavuza oqala olwelwesini lwesisu sakho, ulwelwesi oluncane oluhlanganisa ingaphakathi lomgodi wesisu sakho. Lolu lwelwesi lubizwa ngokuthi i-peritoneum . Cabanga ngalo njengolwelwesi lwebhaluni.

Le peritoneum ihlanganisa nezitho ezibalulekile eziningana ngaphakathi kwesisu sakho. Isibonelo:

• Isinye
• Amathumbu
• I-Rectum
• Isibeletho (esifazane)

Ubuwazi ukuthi le peritoneum yakhiwe uhlobo olukhethekile lweseli olubizwa ngamaseli e-epithelial . Lawa maseli avikela izindawo ezahlukahlukene zomzimba wethu. Futhi, le peritoneum ikhipha uketshezi olukhethekile. Lolu ketshezi yilona oluvumela izitho ezingaphakathi kwesisu ukuthi zihambe ngokukhululeka ngaphandle kokushayisana.

Ngakho-ke, umdlavuza oyinhloko we-peritoneal uqala lapho amangqamuzana e-peritoneum eqala ukukhula ngendlela engavamile futhi engalawuleki.

Manje ake sibheke izinhlobo zomdlavuza we-peritoneal. Odokotela bawuhlukanisa ngezinhlobo ezimbili, kuye ngokuthi umdlavuza uqala kuphi:

1. Umdlavuza oyinhloko we-peritoneal: Kulolu hlobo lomdlavuza, umdlavuza uqala emaseli akha i-peritoneum. Sikhuluma kakhulu ngalolu hlobo namuhla.

2. Umdlavuza wesibili we-peritoneal: Lokhu kwenzeka lapho umdlavuza uqala kwenye indawo emzimbeni (isibonelo, ama-ovari, isisu, amathumbu) bese usakazekela e-peritoneum. Lokhu kusho ukuthi awuqalanga e-peritoneum.

Uvame kangakanani lo mdlavuza oyinhloko we-peritoneal?

Eqinisweni, umdlavuza oyinhloko we-peritoneal uhlobo lomdlavuza olungavamile kakhulu . Cabanga ngakho, lesi sifo sitholakala kubantu abangaphansi kuka-7 kwabayisigidi ngonyaka. Kodwa-ke, lezi zibalo azisitsheli sonke isithombe. Ngokusho kwabanye abacwaningi, cishe u-15% wabesifazane abatholakale benomdlavuza we-ovarian osezingeni eliphezulu bangase babe nomdlavuza we-peritoneal. Ngoba izimpawu zalezi zibili zifana kakhulu.

Ubani osengozini enkulu yokuthuthukisa lokhu?

Abesifazane banamathuba amaningi okuthola umdlavuza we-peritoneal oyinhloko kunabesilisa. Izici eziyingozi zalokhu zifana kakhulu nalezo zomdlavuza wesibeletho. Ake sibheke ukuthi ziyini:

• Ubudala: Lesi sifo sivame ukutholakala kubantu abaneminyaka engu-60 noma ngaphezulu.
• I-Endometriosis:Uma une-endometriosis (isimo lapho amangqamuzana afana nalawo atholakala ongqimbeni lwesibeletho ekhula ngaphandle kwesibeletho), ingozi yakho ingase yande.
• Amathonya ezakhi zofuzo (ufuzo): Uma ilungu lomndeni eliseduze (umama, udadewabo, indodakazi) libe nomdlavuza we-peritoneal, umdlavuza we-fallopian tube, noma umdlavuza we-ovarian, nawe usengozini enkulu. Abesifazane abane -BRCA1 noma i-BRCA2 gene mutations nabo basengozini enkulu. Abantu abanezakhi zofuzo ze- Lynch syndrome (isimo sofuzo esanda ingozi yezinhlobo eziningana zomdlavuza) nabo basengozini enkulu.
• Ukuphakama: Abantu abade kakhulu kunesilinganiso babonakala benengozi enkulu kancane yokuthola lo mdlavuza.
• Ukwelashwa kokushintsha ama-hormone: Abesifazane abathatha ukwelashwa ngama-hormone ngemva kokunqamuka kokuya esikhathini bangase babe sengozini enkulu.
• Ukukhuluphala ngokweqile: Abantu abanamafutha amaningi emzimbeni nabo basengozini enkulu.
• Umlando wokuzala: Le ngozi inganda kancane kulabo abaye baba nobunzima bokuthola abantwana (ukungazali) kanye/noma abangakaze babe nabantwana.

Uyini umehluko phakathi komdlavuza we-peritoneal nomdlavuza we-ovarian?

Yilapho abantu abaningi bedideka khona. Umdlavuza we-peritoneal uqala endaweni ehlukile kunomdlavuza we-ovarian. Umdlavuza we-ovarian uvame ukuqala ema-ovari, noma emaseli asekugcineni kwama-tubes e-fallopian. Kodwa-ke, umdlavuza we-peritoneal, njengoba ngishilo ekuqaleni, uqala emaseli e-peritoneum, ulwelwesi oluhlanganisa ingaphakathi lesisu futhi lumboze izitho ezisesiswini.

Lezi zinhlanzana ezimbili zingadideka kalula. Lokhu kungenxa yokuthi i-peritoneum kanye nolwelwesi lwama-ovari kokubili kwakhiwe uhlobo olufanayo lwamaseli (amaseli e-epithelial). Futhi, ngenxa yokuthi zombili izinhlanzana zisakazeka olwelwesini lwesisu, ngezinye izikhathi kunzima ukukhomba ngqo ukuthi umdlavuza waqala kuphi.

Ngokuvamile, abantu abatholakale benomdlavuza we-peritoneal babadala kunalabo abatholakale benomdlavuza we-ovarian. Kuthiwa futhi ukuthi isibikezelo somdlavuza we-peritoneal singase sibe sibi kancane kunomdlavuza we-ovarian.

Kungani lo mdlavuza oyinhloko we-peritoneal ukhula?

Eqinisweni, abacwaningi abakakazi kahle ukuthi kungani abanye abantu beba nomdlavuza we-peritoneal oyinhloko. Kodwa-ke, njengoba kushiwo ngaphambili, kutholakale ukuthi abantu abazalwa benokuguqulwa kwezakhi zofuzo ezithile basengozini enkulu yokuthola lesi sifo.

Ziyini izimpawu zalokhu?

Njengomdlavuza wesibeletho, lesi sifo asivamile ukukhombisa izimpawu ezigabeni zaso zokuqala . Ngisho noma kunezimpawu, zivame ukungabonakali futhi zingase zifane nezezinye izifo ezivamile. Iningi labantu liba nezimpawu kuphela uma umdlavuza usuqhubeke kakhulu, okusho ukuthi ususakazeke kakhulu.

Kodwa-ke, uma umuntu eba nezimpawu ezigabeni zokuqala, zingaba kanje:

• Ubuhlungu esiswini kanye/noma esiswini esingezansi.
• Ukopha noma ukuphuma kwegazi okungajwayelekile esithweni sangasese sowesifazane.
• Ukuzizwa usuthi, umuzwa wokusinda esiswini noma esiswini esingezansi.
• Izinguquko zamathumbu (ukuqunjelwa kanye/noma ukwanda kwe-flatulence) noma ukopha kwamathumbu.
• Ukudinga ukuchama njalo.
• Izinkinga zokugaya ukudla, ukulahlekelwa yisifiso sokudla, noma ukuzizwa usuthi ngemva kokudla ukudla okuncane kuphela.
• Ukwanda noma ukwehla kwesisindo okungahlosiwe.

Njengoba umdlavuza we-peritoneal uqhubeka, kungase kuvele ezinye izimpawu. Lezi zimpawu zifaka:

• Ukukhathala.
• Ukwakheka koketshezi esiswini (lokhu kubizwa ngokuthi 'ama-ascites ').
• Ukucanuzela noma ukuhlanza.
• Ubunzima bokuphefumula (ukuphelelwa umoya).
• Ukuvuvukala kwemilenze.

Yimiphi imiphumela emibi engaba khona (izinkinga) zalokhu?

Abantu abanomdlavuza we-peritoneal osezingeni eliphezulu bangase babe nezinkinga ezifana nalezi:

• Ubuhlungu obukhulu besisu.
• Ukungakwazi ukudla noma ukuphuza.
• Ukucanuzela okukhulu noma ukuhlanza.
• Ukuvaleka kwamathumbu amancane, ukuvaleka kwamathumbu amakhulu, noma ukuvaleka komgudu womchamo.

Uyithola kanjani ngokunembile lesi sifo?

Uma ubona udokotela, bazoqala bakubuze ngezimpawu zakho bese benza ukuhlolwa ngokomzimba. Uma izimpawu zakho zibonisa umdlavuza we-peritoneal, bangase bakucele ukuthi bahlole okufana nalokhu:

• Ukuhlolwa kwegazi: Lokhu kuhlolwa kwegazi kubheka ikhemikhali ebizwa ngokuthi i-CA-125, ekhiqizwa amanye amangqamuzana omdlavuza. Abantu abanomdlavuza we-peritoneal bangase babe namazinga aphezulu ale nto. Bangase futhi babheke ukwanda kweprotheni ebizwa ngokuthi i-HE4 (engakhiqizwa namangqamuzana omdlavuza we-peritoneal).
• Ukuhlolwa kwezithombe: Ukuhlolwa okufana ne -ultrasound, i-MRI, noma i-CT scan kungabheka ukukhula komdlavuza. Kodwa-ke, lokhu kuhlolwa kungaba nzima ngezinye izikhathi ukukubona ezimweni zomdlavuza we-peritoneal.
• I-Laparoscopy: Ukuze kuqinisekiswe ukuxilongwa, udokotela angenza i-laparoscopy. Lokhu kuhilela ukwenza izimbobo eziningana ezincane esiswini nokufaka ithuluzi elifakwe ikhamera. Phakathi nale nqubo, kuthathwa isampula encane yezicubu ezingavamile (ezibizwa ngokuthi i-biopsy) , bese ihlolwa ngaphansi kwe-microscope yi -pathologist (udokotela ochwepheshe ekuhloleni izicubu) ukuze anqume ukuthi umdlavuza ukhona yini.
• I-Paracentesis: Uma isisu sakho sigcwele uketshezi (olubizwa ngokuthi ama-ascites), udokotela wakho angathatha isampula yoketshezi bese eluhlola. Lokhu kuvame ukwenziwa ngesikhathi se-laparoscopy.
• Ukuhlolwa kwe-pelvic:Isitho sakho sangasese sowesifazane, umlomo wesibeletho, isibeletho, amashubhu e-fallopian, ama-ovari, kanye ne-rectum kuzohlolwa ukuthi azikho yini izigaxa noma izindawo ezingavamile.

Ake sifunde futhi ngezivivinyo ezikhethekile

Uma unezinye zalezi zimo, udokotela wakho angakudlulisela kumeluleki wezakhi zofuzo ukuze akhulume ngezinye zezimo zofuzo ezihlotshaniswa nengozi eyengeziwe yokuba nomdlavuza we-peritoneal:

• Uma ilungu lomndeni eliseduze (umama, udadewabo, indodakazi) libe nomdlavuza we-peritoneal, umdlavuza we-fallopian tube, noma umdlavuza we-ovarian.
• Uma othile emndenini ene-'BRCA1' noma 'BRCA2' yokuguqulwa kwezakhi zofuzo.
• Uma othile emndenini ene-Lynch Syndrome.

Iyini isigaba salo mdlavuza?

Ngenxa yokuthi izimpawu azivamile ukuvela ezigabeni zokuqala zomdlavuza we-peritoneal oyinhloko, umdlavuza uvame ukuba sesigabeni sesi-3 noma sesi-4 lapho utholakala.

• Isigaba 3: Umdlavuza ususakazeke ngaphandle kwe-pelvic cavity noma kuma-lymph node ngemuva kwesisu.
• Isigaba 4: Umdlavuza ususakazekele ezithweni ezingaphandle kwesisu (isib., amaphaphu, isibindi, udende) noma olwelwesini olumboza amaphaphu nesifuba.

Lokhu kuphathwa kanjani futhi kuphathwa kanjani?

Ukwelashwa komdlavuza oyinhloko we-peritoneal kuncike ezintweni eziningana:

• Usayizi nendawo yesimila somdlavuza.
• Isigaba somdlavuza.
• Ubudala bakho kanye nempilo yakho iyonke.

Ngokuvamile, odokotela bazokwenza ukuhlinzwa njengokwelashwa kokuqala. Ungase ube nenqubo ebizwa ngokuthi ukuhlinzwa kwe-cytoreductive . Umgomo walokhu ukususa amangqamuzana omdlavuza amaningi ngangokunokwenzeka. Ucwaningo lukhombisile ukuthi imiphumela iba ngcono uma lokhu kuhlinzwa kwenziwa udokotela wezifo zabesifazane (udokotela ochwepheshe ekwelapheni izifo kanye nomdlavuza wesistimu yokuzala yabesifazane).

Udokotela ohlinzayo angasusa futhi:

• Amashubhu esibeletho kanye nama-ovari (lokhu kubizwa ngokuthi i-'oophorectomy ').
• Isibeletho (lokhu kubizwa ngokuthi 'ukususwa kwesibeletho ').
• Izicubu ezinamafutha ezizungeze amathumbu akho, ezibizwa ngokuthi i-omentum (lokhu kubizwa ngokuthi i-'omentectomy ').
• Ezinye izicubu ezingavamile.

Ukuze uvimbele amangqamuzana omdlavuza ukuthi asakazekele kwezinye izingxenye zomzimba, uhlelo lwakho lokwelapha lungafaka:

• Ukwelashwa ngamakhemikhali: Ukwelashwa ngamakhemikhali okuvamile komdlavuza we-peritoneal kunikezwa ngemithambo noma ngqo emgodini wesisu (intraperitoneal). Kwezinye izimo, odokotela basebenzisa imithi eshisayo yamakhemikhali (lokhu kubizwa ngokuthi i-hyperthermic intraperitoneal chemotherapy (HIPEC)).) isetshenziswa. Lokhu kwelashwa kwe-'HIPEC' kunikezwa ngokushesha ngemva kokuhlinzwa kwe-cytoreductive, ngenkathi usahlinzwa egumbini lokuhlinza, futhi kufakwa emgodini wesisu. Le ndlela ye-'HIPEC' ingaba ngcono kakhulu ekunikezeni i-chemotherapy kweminye imidlavuza.
• Ukwelashwa okuqondiwe: Udokotela angasebenzisa imithi ethile eqondisa amangqamuzana omdlavuza kuphela, ngaphandle kokulimaza amangqamuzana avamile.
• Ukwelashwa ngama-hormone: Ezimweni ezithuthukile, odokotela ngezinye izikhathi bahlanganisa ukwelashwa ngama-hormone ne-chemotherapy. Lokhu kwelashwa kusebenza ngokuvimbela ama-hormone emvelo omzimba wakho ukuthi angafinyeleli kumaseli omdlavuza, kuwavimbele ekukhuleni kwawo.
• Ukwelashwa ngemisebe: Ukwelashwa ngemisebe akuvamile ukusetshenziswa njengokwelashwa kokuqala komdlavuza we-peritoneal. Uma umdlavuza ubuyile ngemva kokwelashwa kokuqala futhi ugcinwe endaweni encane, ukwelashwa ngemisebe kunganikezwa.

Ngingayinciphisa kanjani ingozi yami yokuthola lokhu?

Uma uke wazenza lezi zinto, ingozi yakho yokuba nomdlavuza we-peritoneal oyinhloko ingase yehle kancane:

• Uma izingane zincelisiwe.
• Uma ubelethe izingane.
• Uma uke wathatha amaphilisi okuvimbela inzalo.
• Uma uke wahlinzwa wasusa amapayipi akho e-fallopian kanye/noma ama-ovari.
• Uma amapayipi e-fallopian eboshiwe (ukubopha amapayipi).

Abanye abantu abanomlando womndeni womdlavuza wesibeletho noma labo abanokuguqulwa kwezakhi zofuzo ze-BRCA abasengozini enkulu yokuthola umdlavuza wesibeletho bakhetha ukususwa kwama-ovari nama-tubes abo. Kubalulekile ukukhumbula ukuthi nakuba lokhu kuhlinzwa kunciphisa ingozi yokuthola umdlavuza wesibeletho, akuwuqedi ngokuphelele .

Liyini ikusasa lomuntu onalesi sifo? (Isibikezelo)

Ngenxa yokuthi umdlavuza we-peritoneal uvame ukutholakala esigabeni esilandelayo salesi sifo, ukubikezela okubi akukuhle. Umdlavuza ungaphinde ubuye ngemva kokwelashwa. Kodwa-ke, ukutholakala kusenesikhathi kungasiza ekuthuthukiseni imiphumela.

Cishe ingxenye yabantu abanomdlavuza we-peritoneal, i-fallopian tube, noma i-ovarian baphila iminyaka emihlanu noma ngaphezulu ngemva kokuxilongwa. Nakuba abantu abasebasha benamathuba amaningi okuphila isikhathi eside, isibikezelo kubantu asebekhulile singase sibe sibi kakhulu.

Amazinga okusinda angakhuphuka ezimweni ezinjengalezi:

• Uma umdlavuza ungakasabalali kuma-lymph node akho.
• Uma uke wathola ukwelashwa kwe-'HIPEC'.
• Uma udokotela ohlinzayo esesuse umdlavuza omningi ngangokunokwenzeka.

Izivivinyo eziningana zemitholampilo seziqalile kakade ukuthola izindlela ezintsha zokwelapha umdlavuza we-peritoneal. Lezi zindlela zokwelapha ezintsha zifaka phakathi izindlela zokwelapha eziqondiwe kanye ne-immunotherapy.Ukwelashwa nge-immunotherapy kuhilela ukuvuselela amasosha omzimba wakho ukuze aqaphele futhi ahlasele amangqamuzana omdlavuza emzimbeni wakho.

Kufanele ngizinakekele kanjani?

Ukuze usize ekuphatheni izimpawu zomdlavuza we-peritoneal othuthukile, udokotela wakho angase asikisele ukuthi ubonane nomhlinzeki wemithi yokwelapha ubuhlungu (umkhakha wezokwelapha ogxile ekwehliseni nasekubhekaneni nezimpawu zesimo sezokwelapha esibucayi). Ukunakekelwa kwakho kungafaka:

• Ukunciphisa isicanucanu nokuhlanza.
• Ukubonisana ngokudla okunempilo ukuze uthole izincomo mayelana nesifiso sokudla kanye nokudla.
• Ukuphathwa kobuhlungu.
• I-Paracentesis yokususa uketshezi esiswini sakho (ama-ascites).

Ngingabhekana kanjani kahle nesimo esinjengalesi?

Ukujoyina iqembu lokusekelana nabanye abadlula ekwelashweni okufanayo nawe kungakusiza uzizwe ungedwa kangako. Amaqembu okusekelana angasiza nomndeni wakho ukuthi uqonde ukuthi ubhekene nani.

Umyalezo obaluleke kakhulu okufanele uwuthathe uye nawo ekhaya

Umdlavuza oyinhloko we-peritoneal uhlobo lomdlavuza olungavamile oluvela olwelwesini lwesisu. Izimpawu zivame ukuvela ngemva kokuba umdlavuza usukhulile, ngakho-ke uvame ukutholakala esigabeni esilandelayo. Kodwa-ke, ukwelashwa okuthuthukile njenge-HIPEC, ukwelashwa okuqondiwe, kanye nokuhlinzwa kungathuthukisa imiphumela. Izivivinyo zemitholampilo nazo ziyaqhubeka ukuthola ezinye izindlela zokwelapha ezingakhulisa amazinga okusinda.

Into ebaluleke kakhulu ukuthi uma uqhubeka nokuba nezimpawu ezishiwo ngenhla (ikakhulukazi izinguquko ezingavamile esiswini, ubuhlungu, ukusinda), kufanele nakanjani ufune iseluleko sezokwelapha. Uma kutholakala kusenesikhathi, kulapho kungenzeka khona ukuthi ukwelashwa kuphumelele.

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